非特異性炎症による広範囲食道狭窄の1症例 EXTENSIVE ESOPHAGEAL STENOSIS WITH NON-SPECIFIC INFLAMMATION:REPORT OF A CASE

患者は75歳の男子で脳内血腫にて内科的加療3ヵ月後より嚥下困難を訴え,精査した.X線及び内視鏡検査にてIm～Eiにわたり,狭窄像があり,悪性疾患を完全には否定出来ず,手術を施行した.摘出標本の肉眼所見では食道壁の肥厚を認め,狭窄部の粘膜面は暗赤紫色で小びらんが散在した.組織学的には食道壁全層に炎症性細胞浸潤と粘膜下の線維化が高度に見られ,非特異性炎症の所見であった.本症例は脳内血腫で入院初期におこなった鼻注栄養のための鼻腔ゾンデの挿入が誘因となったと考えられる.

A 75-year-old male in patient with intracranial hematoma complained of dysphagia 3 months after the start of medical treatment. X-ray and esophagoscopic examinations showed a stenosis in the region from Im to Ei but no abnormalities on the esophageal mucosa. Surgical operation was performed for a suspicion of malignant disease, Gross pathological findings showed that the esophageal wall was hypertrophied and small erosions were disseminated in the dark-reddish, violet mucous membrane of the steno-tic region. Histopathological examination showed non-specific inflammation, indicating inflamma-tory cell infiltration and severe submucosal fibrosis in all the layers of the esophageal wall. In this patient, inflammatory changes are considered to be due to a nasogastric tube for feeding early in the hospitalization period.